This is a renewal application to sustain and enhance opportunities for intensive basic, translational and clinical research training in nephrology and related disciplines. After establishing an endowed Chair in the Division into which Dr. Chertow was recruited, the Dean and Department Chair have committed to double the size of the Division of Nephrology from six to 12 or more research-oriented faculty members over the next five years. With a new Program Director, Executive Committee and expanded Training Faculty, we are respectfully requesting re-expansion of the Program to four physician-scientist trainees per year, a level that had been sustained during the 1990s. By combining Stanford's adult nephrology program with the pediatric nephrology program at Lucille Packard Children's Hospital, we can additionally address the severe manpower shortage in pediatric nephrology, and be flexible in recruiting and training the most qualified candidates within both disciplines. We believe that the research opportunities now available to candidates in our program have diversified and expanded considerably since the last submission. Sixteen of the 30 training faculty hold primary or secondary appointments in basic science departments or Institutes (Chemical and Systems Biology, Developmental Biology, Molecular & Cellular Physiology, Computer Science, Cardiovascular Institute, Institute for Immunity, Transplantation and Infection, Institute for Stem Cell Biology and Regenerative Medicine), in the Department of Health Research and Policy or other clinical research institutes and/or other graduate schools at the University. It should be emphasized that ours is the only program at Stanford specifically directed at training physician scientists for research and teaching careers in adult and pediatric nephrology. Moreover, no other training programs at Stanford University emphasize research and training in acute and chronic kidney disease, increasingly recognized as common disorders with serious clinical consequences that incur massive public expense. Thus, continuation of this program - newly titled as the Adult and Pediatric Nephrology Research Training Program - is essential for Stanford to function as a major training center in nephrology research. RELEVANCE: Acute and chronic kidney disease are common conditions that lead to extensive human suffering. Basic, translational and clinical research efforts are required to discover causes and manage consequences of kidney disease. Research training programs in adult and pediatric nephrology are needed to prepare the next generation of physician scientists for careers in biomedical research.